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A 50-Year-Old Male with Speech, Swallowing, and Behavioral Difficulties 

A 50-Year-Old Male with Speech, Swallowing, and Behavioral Difficulties
Chapter:
A 50-Year-Old Male with Speech, Swallowing, and Behavioral Difficulties
Author(s):

Jeffrey A. Cohen

, Justin J. Mowchun

, Victoria H. Lawson

, and Nathaniel M. Robbins

DOI:
10.1093/med/9780190491901.003.0003
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date: 17 June 2021

Treatment issues are discussed in the setting of a very challenging patient with amyotrophic lateral sclerosis with frontotemporal dementia (FTD), including management of neurological symptoms and cognitive dysfunction. Features of FTD are discussed. It is now appreciated that FTD is more common than previously thought. FTD can occur before the onset of motor symptoms. An ALS multidisciplinary clinic is the best approach for the care of ALS patients. Ethical issues are analyzed in this case as well. The need for the discussion of end of life issues is important for the patient family and caregivers. The careful consideration of tracheostomy and ventilator use is important in light of pulmonary function. Pulmonary function testing and sleep studies are helpful in managing respiratory issues. Palliative care consultation can be very beneficial.

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